Psilocybin May Help Reduce Depression Symptoms in People with Cancer

Psilocybin May Help Reduce Depression Symptoms in People with Cancer
29.12.2023
  • People with cancer and serious depression who underwent psilocybin-assisted therapy saw improvements in their depression symptoms over 8 weeks.
  • The psychedelic psilocybin can induce a mystical or spiritual experience and other changes in the brain that may improve patients’ well-being.
  • Experts say more research is needed and highlight that psilocybin as a treatment for depression should be used only with the support of a trained therapist.

People with cancer who underwent psilocybin-assisted therapy in a group setting saw reductions in symptoms of depression, a small clinical trial found.

In the study, 30 people with cancer received a single 25-milligram dose of the psychedelic psilocybin. After 8 weeks, researchers reported, their depression severity scores dropped by an average of 19 points.

In addition, half of study participants showed full remission of depression symptoms after 1 week, an effect that was sustained throughout the 8-week phase 2, open-label trial. Overall, 80% of participants experienced a sustained response.

“Our study provides encouraging insights into the potential benefits of psilocybin-assisted therapy for individuals with cancer and major depression,” said Dr. Yvan Beaussant, a study author as well as a hematologist and palliative care physician at the Dana-Farber Cancer Institute and Harvard Medical School in Boston.

Adverse effects related to the treatment, such as nausea and headache, were “generally mild and expected,” the researchers wrote in their paper published in the journal Cancer.

In addition, there was no indication of suicidal thoughts or behavior.

Profound experience with psilocybin

Around 25% to 33% of people with cancer meet criteria for clinically significant depressive symptoms, the researchers wrote.

This can result in people not adhering to recommended treatments, a lower quality of life, and higher rates of mortality.

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Some research suggests that a psilocybin‐induced mystical or spiritual experience may improve patients’ well-being.

Psilocybin, the active compound in “magic mushrooms,” acts on a certain type of serotonin receptor in the brain, and alters perception, affect, and ego function.

While “we are still learning about how psychedelics change the brain,” said Dr. Akanksha Sharma, a neurooncologist and palliative medicine physician at the Pacific Neuroscience Institute in California,“ at this point we know that altered states of consciousness [associated with psychedelics] can help patients face and process difficult emotions associated with their disease.”

“In this state, with the right guides we can potentially reframe and accept our condition or find peace,” Sharma, who was not involved in the study.

“In addition, the shifts in perspective and reframing can help us think differently about life and death and bring spiritual peace and acceptance,” she added. “This can be very helpful for patients experiencing cancer and depression.”

Need for new depression treatments

In the United States, psilocybin is currently classified as a schedule I drug, meaning it has no accepted medical use and a high potential for misuse.

A growing number of research studies have found that psilocybin-assisted therapy may be an effective treatment for major depressive disorder, including in people with treatment-resistant depression.

However, “while the focus of some studies has been on treatment-resistant depression, our findings in the recent phase 2 clinical trial suggest that psilocybin-assisted therapy may offer benefits to individuals with cancer and major depression, regardless of their previous response to other depression treatments,” Beaussant.

Some of the participants in the new study had not found relief from conventional depression treatments, he noted.

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Beaussant cautions that additional research is needed before psilocybin can be used as a first-line treatment for depression in people with cancer.

There is, however, a need for better treatment of depression in this population. One 2014 study found that only around one-quarter of people with cancer received potentially effective treatments for depression.

On top of that, studies show that “less than half of patients benefit from antidepressants and only a small minority obtain full remission,” said Beaussant.

Guided psychedelic therapy

In the new study, which ran from 2020 to 2021, researchers recruited 30 adults with cancer and major depressive disorder from a single community oncology center.

The average age of participants was 56 years. In addition, 70% were women and 80% were white.

Participants received a single 25-milligram dose of psilocybin, with 8 hours of preparation and integration therapy, and follow‐ups. In total, they had eight visits over 8 weeks with individual and group components.

In a related paper by the same research group, also published in Cancer, researchers found that including group therapy support before and after psilocybin therapy improved patients’ experience of psychedelic treatment.

Sharma highlighted that psychedelic therapy — which involves “opening our mind and heart” — needs to be done with the support of therapists trained to provide this type of treatment.

“Patients should be guided through this,” she said. “Otherwise they can experience anxiety, panic and confusion.” They may also have high blood pressure or cardiac side effects that need to be managed by a medical professional.

Dr. Faisal Tai, a psychiatrist and medical director at PsychPlus who was not involved in the research, cautions that the use of psilocybin for medical purposes is still in the experimental stage.

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“It is always recommended that patients consult with doctors and other healthcare professionals for the latest information and guidance on such treatments,”.

Beaussant agrees that additional research is needed, including on patients with different types of cancer.

“While our findings are promising for a broad spectrum of participants, including those with terminal diagnoses and across cancer types and age groups, it is crucial to approach this with caution,” he said.

In addition, “the complex interplay of individual characteristics, cancer types and stages necessitates further investigation to identify specific subgroups that may derive particular benefits from this therapeutic approach,” he said.

Takeaway

In a small, phase 2 clinical trial, people with cancer and major depressive disorder who underwent psilocybin-assisted therapy had improvements in their depression symptoms over 8 weeks. Half of patients saw full remission after 1 week.

Psilocybin is a psychedelic that is the main active compound in “magic mushrooms.” It can induce a mystical or spiritual state and other changes in the brain that may help people process difficult emotions associated with their disease.

Earlier research has found that psilocybin-assisted therapy may be effective as a treatment for major depressive disorder, including treatment-resistant depression. Additional research is needed before this can be used as a first-line treatment for depression in people with cancer.

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